2017-05-31_REPORT - M1977284

• Permit No: M1977284
• IBM Index Class Name: Report
• Doc Date: 5/31/2017
• Doc Name: Annual Fee/Report/Map
• From: Cotter Corporation
• To: DRMS
• Annual Report Year: 2017
• Email Name: DMC
• Media Type: D
• Archive: No

M-1977-284
Page 5 of 5
Division records indicate the following permittee/landowner contact information (blank fields indicate that we do not have
information on record). If this infonnation is blank or not current, please type or print current contact information:
Permittee Contact:
im-Sheridan-
_
`=Scott Pottorff:'
Permittee Company:
Cotter Corporation
j
Address:
P.O. Box 700
Nucla, CO 81424
Phone Number:
[phone]
970-773-4167
Fax Number:
_(930) -864 -7287 -
Email Address:
,[e-mail]-
[e-mail]
Permitting Contact:
Jim Sheridan. A
Gus Gavi oti s
Company:
Cotter Corporation
Address:
-P-.G.-Box-700-
P:O: Box700-°.Nuc1a,
.Nucla,-CO -8-1424
CO.8.14224
7800 E. Dorado Place Suite 210
Englewood, CO 80111-0700
Phone Number:
-e70)-864=7347T-
720-554-6211
Fax Number:
.[phone]-
720-554-6201
EmailAddress:
4im:[e-mail]
[e-mail]
Inspection Contact:
Jim Sheridan—
Scott Pottorff
Company:
Cotter Corporation
Address:
P.O. Box 700
Nucla, CO 81424
Phone Number:
-(970) 864=7347- - : --
970-773-4167
Fax Number:
Email Address:
im Sheridan@cotterusa:com»
[e-mail]
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
10*
Signature of Permittee, Corporate Officer, Owner, or Documented Designee
M -AF -02
Date
ib